You Could Go Blind Rubbing Your Eyes

KERATOCONUS PATIENTS ARE GETTING YOUNGER! IS SCREEN TIME TO BLAME?

- MURUGANANTH SABAPATHY

Varun (name changed) came to my clinic with a history of blurred vision. He faced glare at night while coming home from tuition on his cycle; he faced severe eye strain, and his spectacle power values kept changing every three months, which was unusual.

He had been wearing eyeglasses and checking his vision every six months, but the numbers kept changing lately. He realised that the clarity became better when he rubbed his eyes, and it became a habit.

He tried every possible solution, from getting blue-cut lenses to anti-reflective coating lenses to photochromatic lenses. Nothing worked. Eventually, the optician sent him to me.

I performed a visual acuity test with a dilated refraction in a dark room. I observed that his cylindrical power was way high, indicating astigmatism. Astigmatism is a condition that causes blurred vision due to the steep corneal surface.

His astigmatism worsened rapidly when I compared his previous glass prescriptions. He was in his final year of school. He spent long hours staying awake and peered at his tablet, which contained most of the worksheets and homework. Back in school, his teachers used a smart board to teach, and the classroom lights were permanently switched off.

His cylinder values were over minus 2. And there was a 50-diopter bump from his older prescription. This can be common for most astigmatic children, teens, and young adults. You see their growth hormone levels peak at this age. But what caught my eye was his Keratometry readings.

Keratometry is the value of the corneal curvature, which is routinely assessed by the auto refractometer. Almost all optical shops and clinics have an auto refractometer. They come out as K1 and K2 values.

For example, a K1 value of 45 and a K2 value of 47 are acceptable. But in Varun's case, K1 was 48, and K2 was 51. This keratometry reading had a very high and wide value. So, I ordered a corneal topography and pachymetry to map his cornea.